This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.

Friday, May 02, 2014

Customised Google Glass Delivers In Spades For A Major Emergency Department. Fascinating Story!

Over the past few months, Beth Israel Deaconess has been the pilot site for a new approach to clinical information technology, wearable computing.

In the Emergency Department, we’ve developed a prototype of a new information system using Google Glass, a high tech pair of glasses that includes a video camera, video screen, speaker, microphone, touch pad, and motion sensor.

Here’s how it works.

When a clinician walks into an emergency department room, he or she looks at bar code (a QR or Quick Response code) placed on the wall. Google Glass immediately recognizes the room and then the ED Dashboard sends information about the patient in that room to the glasses, appearing in the clinician’s field of vision. The clinician can speak with the patient, examine the patient, and perform procedures while seeing problems, vital signs, lab results and other data.

Beyond the technical challenges of bringing wearable computers to BIDMC, we had other concerns—protecting security, evaluating patient reaction, and ensuring clinician usability.

Here’s what we’ve learned thus far:

Patients have been intrigued by Google Glass, but no one has expressed a concern about them. Boston is home to many techies and a few patients asked detailed questions about the technology. Our initial pilots were done with the bright orange frames—about as subtle as a neon hunter's vest, so it was hard to miss.

Staff has definitely noticed them and responded with a mixture of intrigue and skepticism. Those who tried them on briefly did seem impressed.

We have fully integrated with the ED Dashboard using a custom application to ensure secure communication and the same privacy safeguards as our existing web interface. We replaced all the Google components on the devices so that no data travels over Google servers. All data stays within the BIDMC firewall.

We have designed a custom user interface to take advantage of the Glass’ unique features such as gestures (single tap, double tap, 1 and 2 finger swipes, etc.), scrolling by looking up/down, camera to use QR codes, and voice commands. Information displays also needed to be simplified and re-organized.

We implemented real-time voice dictation of pages to staff members to facilitate communication among clinicians.

Google Glass does not appear to be a replacement for desktop or iPad—it is a new medium best suited for retrieval of limited or summarized information. Real-time updates and notifications is where Google Glass really differentiates itself. Paired with location services, the device can truly deliver actionable information to clinicians in real time.

Beth Israel Deaconess Medical Center has modified Google Glass wearable computers so they can be used to treat patients in its emergency department without running afoul of privacy regulations. Using software from a startup, the hospital ensures no data travels over Google’s servers, says Dr. John Halamka, the hospital’s CIO.

“We have total control of all data flowing to and from Glass,” said Mr. Halamka in an interview Thursday.

With Glass, physicians can call up patient data through voice commands and view it on the screen mounted on the device’s eyeglass frame. The setup lets physicians keep their hands free while treating patients.

But Google Inc., which stores Glass-generated data on its cloud, won’t sign the contract hospitals are required to obtain from cloud vendors to meet requirements of the Health Insurance Portability and Accountability Act. HIPPAA requires that cloud vendors accept responsibility for managing patient information in accordance with the law’s privacy rules. This has prevented hospitals such as the Cleveland Clinic from using it.

Beth Israel has found a technological solution to those regulatory concerns. Thanks to software from Wearable Intelligence, a startup in stealth mode, the patient information accessed via Glass stays within the hospital’s computer systems, says Mr. Halamka. Patient records are stored on the hospital’s clinical systems and accessed via an encrypted Web connection. A cache-less browser is used to ensure that no patient data is stored on the device. As a result, if someone removes Glass from the hospital, they won’t be able to access patient data.

Encrypting devices doctors use to treat patients upholds privacy and security provisions in “meaningful use,” a set of government objectives for optimizing the use of electronic health care record software, said Mr. Halamka. Hospitals that meet these objectives are eligible for government incentives.